Oral health policy has only recently focused on the needs of the elderly, the fastest growing segment of the U.S. population. It is unclear what effect the inclusion of dental services into the Medicare package of health care services would have on the elderly's access to dental care. This project provides an unique opportunity to longitudinally examine dental utilization, dental expenditures, and dental service mix for urban elderly participating in a Medicare-waiver dental program. The purpose of this study is to: investigate the effects of a Medicare-waiver dental program on dental utilization, expenditure, and service mix among a traditional nonuser population (i.e., low income, minority elderly); characterize changes in their use of health care services over time; and determine the birth cohort effect on utilization and mix of services provided to this population. This latter point is quite significant since different dental services may be required for different age cohorts within this population. Little longitudinal dental data is available on the characteristics of the low income, elderly population who traditionally lack dental insurance. This secondary data analysis will include elderly dental and medical users of a Medicare-waiver program (1984-1991) from two urban primary health care facilities. Specifically, the investigators will: determine if differences occur in dental utilization, expenditure, and service mix over time as more people enrolled in the Medicare-waiver program (controlling for age, gender, race); determine if there are birth cohort differences in dental utilization, expenditure, and service mix; identify and compare factors which are predictive of dental and medical utilization over time (1984-- 1991); and examine the relationship between dental and medical utilization over time (1984-1991). Univariate results from an earlier survey of a subset of this population indicate that among these noninstitutionalized Medicare-waiver participants (dental and medical), 59 percent are black and 71 percent are female. Black females comprise 41 percent of the entire respondent group. Descriptive statistics for dental utilization, expenditure and service mix will be crosstabulated with types of dental users (regular, infrequent, prosthetic) to ascertain what patterns of utilization, expenditure, and service mix occur over time for each type of dental user group. An intervention time series analysis will be used to determine differences that may occur in birth cohort utilization over time. Logistic regression will be used to model the probability of the use of dental and medical services for each year.